Page 44

WGO Handbook on Diet and the Gut_2016_Final

World Digestive Health Day
WDHD – May 29, 2016
EATING DISORDERS AND THE GI TRACT: DEFINITION,
RECOGNITION, THE ROLE OF THE PSYCHOLOGIST IN CARE, continued
the focus is not related to losing weight or reducing energy
intake. The exclusion of foods that are categorized as less
healthy or pure can lead to malnutrition and have a significant
impact on psychosocial wellbeing. In a recent review,
Varga and colleagues14 identify that the average prevalence of
ON in a general population is 6.9% and up to 57.8% in highrisk
groups such as healthcare professionals and artists.
No research has tested the efficacy of a treatment for ON.15
Koven and Abry15 suggest that a combination of CBT and psychotropic
medication may be efficacious due to the success in
treating AN and Obsessive-Compulsive Disorder. However, recent
research suggests that 30% of outpatients with AN or BN
can go on to develop ON after treatment.16 As such, it is also
important to notice whether a previous restriction or compensation
becomes a preoccupation with food that is categorized
as healthy or impure.
CONCLUSION
Individuals with EDs often have GI symptoms for which they
may seek treatment with a gastroenterologist before seeking
treatment for the symptoms of their ED. This can result in
unnecessary tests, hospitalizations, and missed opportunity
to address their underlying distress. It is an ongoing challenge
for gastroenterologists to identify and support patients
with EDs. However, screening for EDs and establishing a team
approach can help effectively treat EDs and any physical
complications effectively, and work toward the best outcome
for ED patients.
Acknowledgements: The authors would like to thank Ms. Sarina
Cook for her work in reviewing the material and integration
of content. We also thank Janine Lemon, Psychologist
based at the Eating Disorders Unit, Royal Melbourne Hospital,
and Dr. Naomi Crafti, Psychologist and Senior Research Fellow,
Monash University, for their valuable feedback and advice
regarding the article.
REFERENCES
1. American Psychiatric Association: Diagnostic and Statistical
Manual of Mental Disorders (DSM-5®). In., 5. edn.
Washington, D.C.: American Psychiatric Publishing,; 2013:
1 online resource (992 p.).
2. Winstead NS, Willard SG: Gastrointestinal complaints in
patients with eating disorders. Journal of Clinical Gastroenterology
2006, 40(8):678-682.
3. Emmanuel AV, Stern J, Treasure J, Forbes A, Kamm MA:
Anorexia nervosa in gastrointestinal practice. European
Journal of Gastroenterology & Hepatology 2004;
16(11):1135-1142.
4. Porcelli P, Leandro G, De Carne M: Functional gastrointestinal
disorders and eating disorders. Relevance of the
association in clinical management. Scand J Gastroenterol
1998; 33(6):577-582.
5. Satherley R, Howard R, Higgs S: Disordered eating practices
in gastrointestinal disorders. Appetite 2014; 84:240-
250.
6. American Psychiatric Association: Practice guideline for
the treatment of patients with eating disorders. Arlington,
VA: American Psychiatric Association; 2006.
7. National Institute for Clinical Excellence: Eating disorders:
Core interventions in the treatment and management
of anorexia nervosa, bulimia nervosa and related eating
disorders. London: British Psychological Society; 2004.
8. Australian Psychological Society: Evidence Based Psychological
Interventions in the Treatment of Mental Disorders:
A Literature Review; 2011.
9. Shapiro JR, Berkman ND, Brownley KA, Sedway JA, Lohr
KN, Bulik CM: Bulimia nervosa treatment: a systematic
review of randomized controlled trials. International Journal
of Eating Disorders 2007; 40(4):321-336.
10. Brownley KA, Berkman ND, Sedway JA, Lohr KN, Bulik
CM: Binge eating disorder treatment: a systematic review
of randomized controlled trials. International Journal of
Eating Disorders 2007; 40(4):337-348.
11. Bulik C, Berkman N, Brownley K, Sedway J, Lohr K:
Anorexia nervosa treatment: a systematic review of
randomized controlled trials. The International journal of
eating disorders 2007; 40(4):310-320.
12. Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor
L, Touyz S, Ward W: Royal Australian and New Zealand
College of Psychiatrists clinical practice guidelines for the
treatment of eating disorders. Australian and New Zealand
Journal of Psychiatry 2014; 48(11):977-1008.
44 WGO Handbook on DIET AND THE GUT World Digestive Health Day WDHD May 29, 2016